IPPOSI National Strategic Forum for Clinical Research

Clinical Research in Singapore

Edward W. Holmes, MD Chairman NMRC

Deputy Chairman BMRC

  Young country: Achieved independence in 1965

  English speaking workforce: Population-98% literate in English Only Asian country with English as first language

 Open immigration policy: 5 mil population, of which 1 mil are non-Singaporeans

  Visionary leadership: Efficient, effective, ethical

Knowledge-based economy

  Pro-Business Environment Lowest risk business hub #1 Labour Force Strong IP protection laws

India: 1 bil pop GDP(2004): US$ 665bn GDP growth rate: 7%

SE Asia: 520 mil pop GDP(2004): US$ 900bn GDP growth rate: 5%

Australasia: 24 mil pop GDP(2004): US$ 700bn GDP growth rate: 3.5%

China: 1.3 bil pop GDP(2004): US$ 1,600bn

GDP growth rate: 8%

India: 1 bil pop GDP(2005): US$772 bn GDP growth rate: 7.8%

SE Asia: 510 mil pop GDP(2005): US$850 bn GDP growth rate: 5.0%

Australasia: 24 mil pop GDP(2005): US$890 bn GDP growth rate: 2.4%

China: 1.3 bil pop GDP(2005): US$1,930 bn GDP growth rate: 9.3%

*2005 figures are estimates

Half the world’s population in 7 hours

Singapore At a Glance The ‘Heart’ of Asia

Biomedical Sciences Initiative

In 2000 government launched a new initiative to make biomedical sciences one of the pillars of the economy

Phase I focus on buildup of basic biomedical expertise

Biopolis

Phase 2   2 buildings for corporate labs   Additional 400,000 sqft   Construction commenced in June ‘05   Officially opened on 30 October ‘06

Phase 1   2 million sqft   S$500 million invested   Public R&D centres & corporate labs

Shared Facilities   Shared R&D equipment   Shared utilities   Shared animal facility

Phase 4

Phase 3

Phase 3   Request for proposal from developers

by 3Q07   Expected to be ready by 2Q09

2,000 scientists 20 private companies

2.4 mil sqft

Building R&D Capabilities

Before 2000

Institute of Molecular & Cell Biology

(IMCB) ED: Neil Copeland 400 RSEs

*Set-up as BTU in 1990. Became BTC in 1995, established as BTI in 2003 ^ The Centre for Molecular Medicine (CMM) was established in 2004, and was repositioned to Institute of Medical Biology in 2007

Institute of Medical Biology ̂

ED:Birgitte Lane

2005

Singapore Bioimaging Consortium

Chairman: Sir George Radda

Singapore Stem Cell

Consortium Chairman:

Roger Pedersen

Singapore Institute for Clinical Sciences

ED: Judith Swain

Singapore Immunology

Network Chairman: Philippe Kourilsky

2006

Genome Institute of Singapore

(GIS) ED:

Edison Liu 220 RSEs

2003 2001 2000

Bioprocessing Technology

Institute (BTI)* ED:

Miranda Yap 75 RSEs

Institute of Bioengineering &

Nanotechnology (IBN) ED: Jackie Ying

120 RSEs

Bioinformatics Institute (BII) ED: Frank Eisenhaber 120 RSEs

2002

Institute of Chemical

Engineering Sciences (ICES)

ED: Keith Carpenter 170 RSEs

Translational R&D

Background to BMS Phase II In Jun 06, Singapore Government decided that translational & clinical research (TCR) will be a key focus of BMS Phase 2 development

TCR included as part of MOH’s mandate

Multi-agency BMS Exco reconstituted in Jul 06, co-chaired by Chairman, A*STAR & PS(Health)

Formulates policies for all national TCR programs

Integrated Biomedical Sciences Initiative

Research, Innovation & Enterprise Council (RIEC) Chaired by PM Lee Hsien Loong

Steering Committee for Life Sciences (SCLS) Dy Chmn RIEC / Chmn NRF, Ministers of Trade & Industry, Health and Education

Biomedical Sciences Executive Committee Co-chaired by Chairman, A*STAR & Permanent Secretary (Health)

Infrastructure Capital WG

Intellectual Capital WG

Human Capital WG

Biomedical Research Council (BMRC), A*STAR

(Chmn: Prof Sir George Radda) (Deputy Chmn: Prof E. Holmes)

National Medical Research Council (NMRC),

Ministry of Health (Exec Chmn: Prof Edward Holmes)

BMS International Advisory Council

(BMS IAC)

National R&D Framework 2006 - 2010

Public / Private Universities Corporate Research Units

Hospitals Polytechnics A*STAR RIs

Others e.g. Think-tanks, Institutes

Private Labs

S$5b S$1.05b S$7.5b

S$5.4b S$2.1b

A*STAR

CABINET

MTI MOE

EDB Academic Research

Fund (AcRF)

Research, Innovation & Enterprise Council (RIEC)

National Research Foundation (NRF)

New Initiatives and programs to develop new growth areas &

new capabilities

R&D Performers

S$13.55b

S$1.55b for Translational

& Clinical Research

MOH

Key Recommendations

INDUSTRY

BENCH Key performers: A*STAR BMRC RIs,

universities

BEDSIDE Key performers:

MOH (viz. hospitals, specialist centres)

>> Grow health services, public health research

>> Build critical mass of human capital, supernumerary to clinical service needs

>> Establish flagship programmes from bench-to-bedside (heart/ metabolic, neuro, cancer, eye, infectious disease)

Driven by A*, EDB,

Bio*One Driven by

EDB, Bio*One

>> Develop best enabling resources in Asia for translational research

>> Strengthen regulatory framework for translational and clinical research.

Driven by multi-agency BMS

Exco

Interaction strengthened by new entities arising from hospital-medical school partnerships

>> Develop strong investigational med capability

>> Be preferred site for early phase

clinical trials in Asia

•  Singapore Translational Research Investigator Awards (STaR): full salary & $1M pa grant

•  Clinician Scientist Awards (CSA): full salary & $250K pa grant

 Master of Clinical Investigation 8 awardees (Target 15/year)  AST-PhD Scholarship 5 awardees (Target 4/year)  MD- PhD trainees 2 awardees (Target 10/year)  MBBS-PhD (local and UK) 24 (Target 6/year) ________________

Clinician Investigator •  In depth training in clinical

specialty •  Limited research training •  Spends >70% time engaged

in patient care; collaborator with clinician or basic scientist

•  Non-hospital support for time spent in research collaboration

•  Aims to establish Singapore as a leader in 5 strategic disease-orientated areas

•  It achieves this by building on existing, local, highly competitive programmes and providing highly productive platforms for collaboration with top overseas research institutions and industry

•  The 5 TCR programmes awarded are:

•  Each award is worth S$25mil over 5 years

Singapore Tissue Network (STN) National resource for collection, storage, and retrieval of human tissue samples to support translational and clinical research

Singapore Consortium for Cohort Studies (SCCS)

Common infrastructure for coordination of cohort studies and collection of

phenotypic data

Clinical Research Infrastructure in Singapore Clinical Imaging Research Centre (CIRC)

• National resource for research imaging in humans open to all biomedical researchers in Singapore

• Aims: –  Participating in research studies –  Development & testing of new imaging

technologies –  Focus on key areas of national biomedical

research interest –  Training of faculty & students

Pre-Clinical Research Infrastructure in Singapore

National Breeding Centre for SPF research animals •  Local supply of mice & rats and support services

•  Breed high quality standard strains required by Singapore investigators

Development of National Large Animal Research Facility

•  Minipigs

•  Non-human primates

 Formation of 1st AMC: NUHS in 2008

 Developing 2nd AMC: SGH and Duke-NUS GMS

 Stand alone corporate entity; independent board

 NUS School of Medicine (MOE) and National University Hospital (MOH) fused

 Cancer and Heart Centers established

 Chief Executive over SoM and NUH

 Singapore General Hospital; SERI, NCC, NHC

 Duke/NUS Graduate Medical School-opened 2006

 Separate corporate entities at present

Strategic Infrastructure Grants

New research buildings

Investigational Medicine Units (IMU)

Animal research labs

Investigational Medicine

Phase 1 Phase 3 Phase 2 Phase 4,

Epidemiology, HSOR studies

Investigational Medicine Unit At Kent Ridge Campus

Investigational Medicine Unit At Outram Campus

Singapore Clinical Research Institute (SCRI)

• National, one-stop centre for private/public investigators who wish to conduct late-phase clinical research in Singapore

• Provides services such as study design, project & data management, biostatistics, study reporting on a fee-for-service basis

• Develops specialized training courses • Conducts in-house research

Clinical Research Infrastructure in Singapore Investigational Medicine Units

Singapore’s Focus in Clinical Research

Asian Phenotype

Focus on Diseases of Interest to Singapore or Special Ability to Study in Singapore

Investigational Medicine and POC Studies